angiographic catheter one through which a contrast medium is injected for visualization of the vascular system of an organ. Such catheters may have preformed ends to facilitate selective locating (as in a renal or coronary vessel) from a remote entry site. They may be named according to the site of entry and destination, such as femoral-renal and brachial-coronary.

arterial catheter one inserted into an artery, used as part of a catheter-transducer-monitor system to continuously observe the blood pressure of critically ill patients. An arterial catheter also may be inserted for x-ray studies of the arterial system and for delivery of chemotherapeutic agents directly into the arterial supply of malignant tumors.

atherectomy catheter a catheter containing a rotating cutter and a collecting chamber for debris, used for atherectomy and endarterectomy; it is inserted percutaneously under radiographic guidance.

balloon catheter (balloon-tip catheter) a catheter with a balloon at the tip that may be inflated or deflated while the catheter is in place to create, enlarge, or occlude a passageway; see also balloon angioplasty. The pressure-sensitive balloon may be used to facilitate hemodynamic monitoring.

Braasch bulb catheter a bulb-tipped ureteral catheter used for dilation and determination of the inner diameter of the ureter.

Brockenbrough transseptal catheter a specialized cardiac catheter with a curved steel inner needle that can puncture the interatrial septum; used to catheterize the left ventricle when the aortic valve cannot be crossed in a retrograde approach.

cardiac catheter a long, fine catheter especially designed for passage into the chambers of the heart, usually through a peripheral blood vessel under fluoroscopic control. See also cardiac catheterization.

fluid-filled catheter an intravascular catheter connected by a saline-filled tube to an external pressure transducer; used to measure intravascular pressure.

Fogarty catheter a type of balloon-tip catheter used to remove thrombi and emboli from blood vessels.

Foley catheter an indwelling catheter retained in the bladder by a balloon inflated with air or liquid; see illustration.

Three-way Foley catheter. Three separate lumens are incorporated within the round shaft of the catheter for drainage of urine, inflation, and introduction of irrigating solutions into the bladder.

Gensini coronary catheter a catheter used for coronary arteriography, having an end-hole to accommodate a guidewire or monitor pressure as well as side holes for rapid injection of large volumes of contrast material.

Groshong catheter a single or double lumen cardiac catheter inserted into the right atrium with an external port. Unlike the Hickman and Broviac catheters, this type has a valve at the distal end, eliminating the need for clamping and preventing blood from entering it when not in use.

Gruentzig balloon catheter a flexible balloon catheter with a short guidewire fixed to the tip, used for dilation of arterial stenoses; the balloon is made of low-compliance plastic to reduce the risk of arterial rupture.

Hickman catheter a type of central venous catheter used for long term administration of substances via the venous system, such as antibiotics, total parenteral nutrition, or chemotherapeutic agents; it can be used for continuous or intermittent administration and may have either a single or a double lumen.

indwelling catheter a urethral catheter designed to be held in place to drain urine from the bladder.

manometer-tipped catheter one with a small pressure transducer on its tip; used in measuring intravascular or intracardiac pressure.

multipurpose catheter

1. a catheter with several functions or applications.

2. a catheter for coronary angiography that is shaped so that it can be used in either coronary artery.

nasal catheter one made of flexible rubber or plastic with several holes near the end; used for the administration of oxygen. Called also oropharyngeal catheter.

NIH catheter one used for coronary arteriography; it has a closed end and several side holes for rapid injection of large volumes of contrast material.

olive-tip catheter a ureteral catheter with an olive-shaped end, used to dilate a constricted ureteral orifice; larger sizes are also used for dilating or calibrating the diameter of urethral strictures.

central venous catheter

a catheter that is threaded through the internal jugular, antecubital, or subclavian vein, usually with the tip resting in the superior vena cava or the right atrium of the heart. It is also used to administer fluids or medications for hemodynamic monitoring and to measure central venous pressure.

Central venous catheter placement through the subclavian vein

central venous catheter

Central line, central venous access catheter, Hickman catheter Hospital care A thin flexible device inserted into a large vein and used to establish a diagnosis–by drawing blood or administering therapy

cen·tral ve·nous cath·e·ter

(CVC) (sen'trăl vē'nŭs kath'ĕ-tĕr)

Tube surgically inserted into a vein in the central circulation (usually the superior vena cava). Commonly used for long-term IV therapy, nutritional support, or chemotherapy.

CENTRAL VENOUS CATHETER: A tunneled central venous catheter is inserted through subcutaneous tissue in the chest wall into the jugular or subclavian vein

CENTRAL VENOUS CATHETER (SUBCLAVIAN)

central venous catheter

A catheter inserted into the superior vena cava to permit intermittent or continuous monitoring of central venous pressure, to administer fluids, medications or nutrition, or to facilitate obtaining blood samples for chemical analysis. See: illustration

Patient care

Health care professionals must use caution to prevent life-threatening complications when inserting and maintaining a central line. The subclavian approach to the placement of a central line is preferred, because femoral placements may be complicated by deep venous thrombosis, and internal jugular sites carry an increased risk of infection. Sterile technique is a requirement during insertion. The skin should be prepared with chlorhexidine-gluconate (2%) or povidone-iodine. Ultrasound guidance improves the likelihood of entering the desired vein without injury to neighboring structures. With or without radiological guidance, the best results are obtained by practitioners who perform the procedure frequently. After the catheter is inserted, it should be firmly sewn to the skin to keep it from migrating in and out of the insertion site. An antibiotic impregnated patch covered by a sterile dressing should be placed at the insertion site. The catheter should be manipulated as infrequently as possible during its use. Dressing changes are carried out using sterile technique. IV tubing and solutions and injection caps also should be changed as required by the agency’s protocol. Health care professionals are responsible for preventing, assessing for, and managing central venous therapy complications (e.g., air embolism; cardiac tamponade; chylothorax, hemothorax, hydrothorax, or pneumothorax; local and systemic infections; and thrombosis). Documentation should include preprocedure and postprocedure physical assessment of the patient, catheter type and size, insertion site location, x-ray confirmation of the placement, catheter insertion distance (in centimeters), and the patient’s tolerance of the procedure. Maintenance care procedures also should be fully documented. The site should be carefully inspected for inflammation, and any drainage should be cultured. When catheter-related infections are suspected, the catheter tip provides valuable information about infection sources in cases of sepsis. The tip should be cut off with sterile scissors and dropped directly into a sterile specimen container.

one through which a contrast medium is injected for visualization of the vascular system of an organ. Such catheters may have preformed ends to facilitate selective locating (as in a renal or coronary vessel) from a remote entry site. They may be named according to the site of entry and destination, such as femoral-renal and brachial-coronary.

arterial catheter

one inserted into an artery and utilized as part of a catheter-transducer-monitor system to continuously observe the blood pressure of critically ill patients. An arterial catheter also may be inserted for x-ray studies of the arterial system and for delivery of chemotherapeutic agents directly into the arterial supply of malignant tumors.

butterfly catheter

a metal needle with flexible plastic 'wings' and a short length of tubing. The 'wings' assist in placement and facilitate fixation with tape.

a long, fine catheter especially designed for passage, usually through a peripheral blood vessel, into the chambers of the heart under fluoroscopic control. See also cardiac catheterization.

cardiac biopsy catheter

introduced intravenously under the direction of fluoroscopy, can be positioned in the right or left ventricle and an endocardial biopsy obtained.

central venous catheter

a long, fine catheter inserted into a vein for the purpose of administering through a large blood vessel parenteral fluids (as in parenteral nutrition), antibiotics and other therapeutic agents. This type of catheter is also used in the measurement of central venous pressure. See also central venous catheterization.

column disk catheter

an indwelling device for continuous peritoneal dialysis. It is implanted within the peritoneal cavity, resting against the body wall. The attached Silastic tubing is used for infusing and draining the dialysate at intervals.

double-lumen catheter

one having two channels; one for injection and one for removal of fluid.

catheter drainage

a catheter left in place to keep the bladder drained. Preferably should have a one-way valve to avoid aspiration of air and infection.

elbowed catheter

a catheter bent at an angle near the beak.

indwelling catheter

one especially designed so that it is held in place in the urethra for the purpose of draining urine from the bladder.

over-the-needle catheter

a large-bore sharp needle housed with an indwelling stilette, inside a thin-walled plastic tube. An incision is made over the filled vein, the needle-cannula inserted, the stilette withdrawn, then the needle, leaving the plastic cannula in situ.

self-retaining catheter

one constructed to remain in the bladder, effecting constant drainage.

through-the-needle

the catheter is housed within the needle which is used to enter the blood vessel. After insertion, the needle may be removed by withdrawing, but leaving the catheter in place. A protective housing may be provided to cover the needle.

tracheal catheter

one with small holes at the terminal 1 inch, especially designed for removal of secretions during tracheal suctioning.

ureteral catheter

a long, extremely small gauge catheter designed for insertion directly into a ureter.

urethral catheter

any of various types of catheters designed for insertion via the urethra into the urinary bladder. See also catheterization.

A critical appraisal of the two randomized controlled trials examining this topic in critically ill patients has shown that heparin-bonded central venous catheters significantly reduced the incidence of catheter-related thrombosis and infection in children and adults.

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